There were also no significant differences in rates of biochemical, regional or distant failures between the two arms.

Author's Conclusions

With a median follow up of 78 months this randomized study indicates that long-term ADT can be safely reduced from 36 to 18 months without compromising any outcomes in patients with high-risk prostate cancer.

This decrease will presumably decrease toxicity related to ADT and improve QOL, however the analysis on quality of life is still pending analysis.

Clinical Implications

A standard treatment approach of patients with high-risk prostate cancer is radiotherapy with 2-3 years of neoadjuvant, concomitant and adjuvant ADT.

Due to the fact that ADT has significant morbidity, there is much interest in attempting to decrease the duration of this therapy.

This trial indicates that the duration of ADT can safely be decreased from 36 to 18 months with similar outcomes.

This shortened therapy would presumably be better tolerated, however toxicity data from the trial is still pending.

In addition, this trial was started before the benefit of dose-escalated radiotherapy (of greater then 78 Gy) was established in prostate cancer and all patients were treated to 70 Gy.

With dose escalated radiotherapy the duration of ADT could potentially be safely shortened to less then 18 months and further research could be designed to address this question.